Covid-19 High Attack Rate Can Lead to High Case Fatality Rate

  1. Tareef Fdahil Raham

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Abstract

Background

During the current Covid-19 pandemic case fatality rate (CFR) estimates were subjected to a lot of debates regarding the accuracy of its estimations, predictions, and the reason of across countries variances. In this context, we conduct this study to see the relationship between attack rate (AR) and CFR.

The study hypothesis is based on two: 1-evidence suggests that the mortality rate (MR) has a positive influence on case fatality ratio (CFR), 2- and increase number of Covid-19 cases leads to increased mortality rate (MR).

Material and methods

Thirty countries and territories were chosen. Inclusion criterion was > 500 Covid-19 reported cases per 10,000 population inhabitants. Data on covid-19 cases and deaths was selected as it was on March 10, 2021. Statistical methods used are descriptive and one-sample Kolmogorov-Smirnov (K-S), the one-way ANOVA, Levene, least significant different (LSD), and matched paired-samples T-tests.

Results

ANOVA test showed a significant difference at P<0.01 among all studied groups concerning AR and CFR mean values. Group of countries with MR ≥ 15 death / 10 4 inhabitants recorded the highest level of crude mean CFR and AR values, and recorded the highest gap with leftover groups, especially with countries reported MR of <10 death/ 10 4 inhabitants. There were independence 95% confidence intervals of mean CFR and AR values between countries with ≥ 15 death / 10 4 MR and countries with MR of <10 death /10 4 . There was a significant difference between countries with MR ≥ 15 death / 10 4 inhabitants and countries with MR of <10 death / 10 4 inhabitants groups through least significant difference (LSD) test for CFR%(0.042 p-value) and Games Howell (GH) test for AR/10 4 (p-value 0.000).

Conclusions

Total and mean AR and CFR are higher in high MR countries compared to low MR countries.

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  1. ScreenIT

    SciScore for 10.1101/2021.03.23.21254184: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    Institutional Review Board Statementnot detected.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.
    Sex as a biological variablenot detected.

    Table 2: Resources

    Software and Algorithms
    SentencesResources
    Crude COVID-19 CFR was calculated as the total number of COVID-19 deaths divided by the number of total COVID-19 confirmed cases by march 10,2021 multiplied by 100. Methodology: The following statistical data analysis approaches were used under the application of the statistical package (SPSS) ver. (22.0): Descriptive data analysis: Mean value, standard deviation, standard error, (95%) confidence interval, and graphical presentation by using Bar Charts.
    SPSS
    suggested: (SPSS, RRID:SCR_002865)

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

    Results from LimitationRecognizer: An explicit section about the limitations of the techniques employed in this study was not found. We encourage authors to address study limitations.

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a protocol registration statement.

    About SciScore

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  2. Version published to 10.1101/2021.03.23.21254184v2 on medRxiv
  3. Version published to 10.1101/2021.03.23.21254184v1 on medRxiv